Case Reports
Colchicine and indomethacin for the treatment of relapsing polychondritis,☆☆

https://doi.org/10.1067/mjd.2002.105477Get rights and content

Abstract

This report describes the effectiveness of oral colchicine and indomethacin in the maintenance phase of treatment of relapsing polychondritis. Systemic corticosteroids are commonly used in the induction phase of managing cases of relapsing polychondritis. Clinicians are then faced with the challenge of controlling the patient's symptoms while trying to decrease the dose of steroid. (J Am Acad Dermatol 2002;46:S22-4.)

Section snippets

Case report

A 63-year-old man presented for evaluation to the Charles C. Harris Skin and Cancer Center of New York University. His medical history included a cardiovascular accident in June 1996 with residual right eye blindness, hypothyroidism, tinnitus since childhood, and sporadic burning ears since August 1996. The patient had a family history of diabetes mellitus, and his medications included L-thyroxine, nicotinic acid, and amoxicillin-clavulanate. He denied a personal history of arthritis. On

Discussion

Our patient's clinical findings clearly met the diagnostic criteria of McAdam et al.2 Traditional management of relapsing polychondritis typically includes systemic corticosteroids, and prednisone was our initial treatment. Although the waxing and waning nature of this disease is well known, the minimum tolerable dosage of prednisone was significantly decreased with the addition of colchicine and then indomethacin. In addition, the rapid clearing of the patient's symptoms within 48 hours of

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      It is used rarely [23]. Colchicine may be effective in non-severe auricular chondritis and peripheral articular chondritis [28,106–108]. More recently, clinical case reports have described leflunomide [109] and high-dose intravenous immunoglobulins [110] as being effective.

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      Citation Excerpt :

      A literature review provided treatment options based on disease severity and organ involvement. In 1 case, colchicine and indomethocin were effective as steroid-sparing therapies in a patient with refractory auricular chondritis and episcleritis who had failed azathioprine (49,50). However, most patients described in the literature were treated with varying doses of corticosteroids as first-line therapy and other DMARDs or biologics were initiated in an attempt to taper the corticosteroid dosage and maintain remission.

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    This supplement is made possible through an unrestricted educational grant from Stiefel Laboratories to the American Academy of Dermatology.

    ☆☆

    Reprint requests: Andrew G. Franks, Jr, MD, Department of Dermatology, 560 1st Ave, Ste H100, New York, NY 10016.

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